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At least 19 recordsLinked to original sources

Computational Pathology for Accurate Prediction of Breast Cancer Recurrence: Development and Validation of a Deep Learning-Based Tool.

Accurate recurrence risk stratification is crucial for optimizing treatment plans for breast cancer patients. Current prognostic tools like Oncotype DX offer valuable genomic insights into hormone receptor-positive and human epidermal growth factor receptor-negative patients but are limited by cost and accessibility, particularly in underserved populations. In this study, we present Deep-Breast-Cancer-Recurrence (BCR)-Auto, a deep learning-based computational pathology approach that predicts breast cancer recurrence risk from routine hematoxylin and eosin-stained whole slide images. Our methodology was validated on 2 independent cohorts: The Cancer Genome Atlas Program breast cancer data set and an in-house data set from The Ohio State University. Deep-BCR-Auto demonstrated robust performance in stratifying patients into low- and high-recurrence risk categories. On The Cancer Genome Atlas Program breast cancer data set, the model achieved an area under the receiver operating characteristic curve of 0.827, significantly outperforming the existing weakly supervised models (P = .041). In the independent The Ohio State University data set, Deep-BCR-Auto maintained strong generalizability, achieving an area under the receiver operating characteristic curve of 0.832, along with 82.0% accuracy, 85.0% specificity, and 67.7% sensitivity. These findings highlight the potential of computational pathology as a cost-effective alternative for recurrence risk assessment, broadening access to personalized treatment strategies. This study underscores the clinical utility of integrating deep learning-based computational pathology into routine pathological assessment for breast cancer prognosis across diverse clinical settings.

Humans

[Theoretical aspects of fighting cancer recurrence (author's transl)].

The noticeable improvement in the supply of glucose and oxygen to surviving cancer cells located far from the capillary region (primarily very slowly proliferating or non-proliferating cancer cells) can be taken as the main reason for cancer recurrence in the wake of successful tumour treatment with destruction of a high percentage of cancer cells. On the basis of theoretical and experimental research work on substrate supply, cell kinetics and therapy mechanisms in the intercapillary region, therapeutic steps are formulated which act on cancer cells situated at a greater distance from the capillaries and, therefore, against the genesis of cancer recurrence as such.

Antineoplastic Agents

[Treatment of bladder cancer recurrences].

Chemical antitumor drugs employed by the authors failed to render any cytostatic effect on bladder cancer recurrences. Only surgical treatment might provide a short-term remission. The best results of treatment for recurrent bladder cancer were gained in the combination therapy (surgery and radiotherapy) and also while using distant gammatherapy.

Adult

Serum, Cell-Free, HPV-Human DNA Junction Detection and HPV Typing for Predicting and Monitoring Cervical Cancer Recurrence.

Almost all cervical cancers are caused by human papillomaviruses (HPVs). In most cases, HPV DNA is integrated into the human genome. We found that tumor-specific, HPV-human DNA junctions are detectable in serum cell-free DNA of a fraction of cervical cancer patients at the time of initial treatment and/or at six months following treatment. Retrospective analysis revealed these junctions were more frequently detectable in women in whom the cancer later recurred. We also found that cervical cancers caused by HPV types outside of phylogenetic clade α9 had a higher recurrence frequency than those caused by α9 types in both our study and The Cancer Genome Atlas cervical cancer database, despite the higher prevalence of α9 types including HPV16 in cervical cancer. Thus, HPV-human DNA junction detection in serum cell-free DNA and HPV type determination in tumor tissue may help predict recurrence risk. Screening serum cell-free DNA for junctions may also offer an unambiguous, non-invasive means to monitor absence of recurrence following treatment.

DNA integration

How prevalent is fear of cancer recurrence beyond 5 years: a systematic review of validated assessments across tumour types.

PURPOSE: Fear of cancer recurrence (FCR) is an established challenge for cancer survivors. Research however has largely focussed early in treatment, with varying assessments and often single tumour sites. This systematic review set out to determine prevalence of FCR in survivors beyond 5 years across all tumour types. METHOD: We designed a search strategy to identify publications assessing FCR in survivors beyond 5 years with sample size greater than 50, using validated measures. Applying PRISMA methodology and with defined inclusion and exclusion criteria two authors independently assessed the studies for eligibility. Data extraction recorded number of participants, tumour type, study design, FCR tool, time points for assessment and reported prevalence. Risk of bias was assessed to address quality. RESULTS: Ten papers were included, reporting FCR from 5 years to beyond 20 years. Validated tools employed were FCRI-SF and FOP-Q-SF. Sample sizes ranged from 64 to 5983 participants, with a heterogeneous mix of tumour types and age. Only two studies reported longitudinal measurements. Prevalence of FCR above defined threshold ranged from 13 to 33.9% for those studies with acceptable risk of bias reporting distinct cohorts beyond 5 years. CONCLUSION: The limited evidence suggests that clinically relevant FCR persists in some survivors at 5 years. Our review demonstrates the challenge of heterogeneous patient populations in FCR research emphasising the need for improved consensus on measurements and more prospective longitudinal research representing a comprehensive variety of tumour types. We address the clinical implications of persistent FCR and the need to implement effective interventions.

Humans

[Differential diagnosis of cancer recurrence and cicatrical stricture of esophageal anastomosis].

A careful analysis was made of the causes, terms of occurrence and course of cancer recurrence in the area of gastrointestinal and gastroesophageal anastomoses after 498 gastrectomies, resections of the cardia and esophagus for cancer. The possibility of the differential diagnosis between the recurrence and cicatricial strictures of esophageal anastomoses is shown. Based on the clinico-roentgenological data etiopathogenetically 3 variants of cicatricial strictures were singled out: a) due to technical errors, inadequate anastomotic sutures and fistulas; b) due to grave anastomositis, and c) due to reflux-esophagitis. Among cancer recurrences at the site of esophageal anastomosis three forms were differentiated, depending on the origin of recurrence and a form of tumor growth: exophitic, endophitic and paraesophageal recurrence. Special attention is given to an early recurrence and the development of it against the background of pre-existing cicatricial stricture of the anastomosis.

Adult

Serum, cell-free, HPV-human DNA junction detection and HPV typing for predicting and monitoring cervical cancer recurrence.

Almost all cervical cancers are caused by human papillomaviruses (HPVs). In most cases, HPV DNA is integrated into the human genome. We found that tumor-specific, HPV-human DNA junctions are detectable in serum cell-free DNA of a fraction of cervical cancer patients at the time of initial treatment and/or at 6 months following treatment. Retrospective analysis revealed these junctions were more frequently detectable in women in whom the cancer later recurred. We also found that cervical cancers caused by HPV types outside of phylogenetic clade α9 had a higher recurrence frequency than those caused by α9 types in both our study and The Cancer Genome Atlas cervical cancer database, despite the higher prevalence ofα9 types, including HPV16, in cervical cancer. Thus, HPV-human DNA junction detection in serum cell-free DNA and HPV type determination in tumor tissue may help predict recurrence risk. Screening serum cell-free DNA for junctions may also offer an unambiguous non-invasive means to monitor absence of recurrence following treatment.

Humans

Elective irradiation of the lower cervical region in patients at high risk for recurrent cancer at the tracheal stoma.

The results of treatment for recurrent cancer at the tracheal stoma have been poor. From 1971 to 1976, elective postoperative irradiation of the neck was given to 26 high-risk patients with carcinoma of the larynx and hypopharynx. None of the 22 patients whose stomas were irradiated developed stomal or peristomal recurrence, while 2 of the 4 patients whose stomas were shielded had stomal recurrence. Elective irradiation of the tracheal stoma was effective in preventing stomal recurrence; we recommend inclusion of the stomal area in preoperative or postoperative irradiation to the lower cervical region for high-risk patients.

Carcinoma, Squamous Cell

The association between smoking cessation before and after diagnosis and non-muscle-invasive bladder cancer recurrence: a prospective cohort study.

BACKGROUND: Smoking is a major risk factor for bladder cancer, but the relationship between smoking cessation after initial treatment and bladder cancer recurrence has been investigated less frequently and not prospectively yet. METHODS: 722 non-muscle-invasive bladder cancer (NMIBC) patients (pTa, pT1, and CIS) from the prospective Bladder Cancer Prognosis Programme (BCPP) cohort, selected in the UK between 2005 and 2011, provided complete data on smoking behavior before and up to 5 years after diagnosis. The impact of smoking behavior on NMIBC recurrence was explored by multivariable Cox regression models investigating time-to-first NMIBC recurrence. RESULTS: Over a median follow-up period of 4.21 years, 403 pathologically confirmed NMIBC recurrences occurred in 210 patients. Only 25 current smokers at diagnosis quit smoking (14%) during follow-up and smoking cessation after diagnosis did not decrease risk of recurrence compared to continuing smokers (p = 0.352). CONCLUSIONS: Although quitting smoking after diagnosis might reduce the risk of recurrence based on retrospective evidence, this is not confirmed in this prospective study because the number of NMIBC patients quitting smoking before their first recurrence was too low. Nevertheless, this indicates an important role for urologists and other health care professionals in promoting smoking cessation in NMIBC.

Aged

The association of body weight with recurrent cancer of the breast.

Recurrence of carcinoma of the breast after radical mastectomy was associated with preoperative body weight among patients observed for up to 24 years. Patients who had no axillary lymph node metastases and who weighed 130 pounds or less had an accumulative recurrence free survival superior to that of heavier patients. The advantage was unassociated with significant differences in menopausal status, clinical stage, or tumor size. High fat diet and large body mass have been linked epidemiologically with high risk for breast cancer; whatever biologic mechanisms are involved may also promote growth of residual tumor after potentially curative surgery. Diet and weight reduction may represent empirical means for improving the prognosis of heavy individuals with early stages of breast cancer.

Body Weight

Breast Cancer Recurrence Status Assessment in 5 Years Using Multimodal Integrated Learning: A Feasibility Study.

Despite advances in breast cancer detection and treatment, recurrence after curative therapy continues to impact long-term survival and quality of life. Therefore, early identification of high-risk patients is crucial to guide personalized treatment and follow-up strategies. Although genomic assays provide valuable prognostic insights, their high cost and limited accessibility hinder widespread adoption in clinical practice. Recent machine learning or deep learning approaches leveraging clinical, imaging, or multimodal data have shown promise but do not reflect real-world clinical scenarios. This study proposes a deep learning-based multimodal framework for predicting 5-year breast cancer recurrence using routinely collected clinical data. The framework consists of three main components. First, we adopted automated tumor segmentation with MedSAM to extract the tumor region from ultrasound images. The radiomics features are extracted from those tumor regions. Second, report features are extracted using a Med-Contrastive Pre-trained Transformers (MedCPT)-based approach incorporating predefined, clinically informed queries. Third, a multimodal integration model jointly processes image, radiomics, clinical features, and report features through modality-specific branches. The image branch employs the Ultrasound Foundation Model (USFM) as the backbone, while structured tabular data is processed using the FT-Transformer architecture. The features of all branches are fused using a mixture-of-experts (MoE)-based classifier, and the entire model is trained using a progressive fusion training strategy. Experimental results confirm the feasibility of using ultrasound images with tumor mask integration for recurrence prediction and demonstrate the additive value of integrating multiple data modalities through the proposed multimodal integration model. The final model for recurrence prediction achieved an AUC of 0.7540, accuracy of 74.61%, sensitivity of 70.41%, and specificity of 76.44%. This feasibility study's findings underscore the potential of the proposed multimodal deep learning framework to provide accessible, accurate, and generalizable recurrence risk prediction using routinely available clinical data, potentially supporting more informed treatment decisions and personalized post-treatment monitoring in real-world clinical practice.

Breast cancer recurrence

Detection and treatment of recurrent cancer of the colon and rectum.

A series of 177 patients with recurrent colorectal cancer treated at the Massachusetts General Hospital is examined retrospectively. Two thirds of recurrences were observed by the second postoperative year, and 15% of patients were asymptomatic. Pelvic recurrences were usually attributable to rectal or sigmoid tumors, whereas right-sided carcinomas frequently spread to the liver. The commonest methods of clinical discovery of recurrence included findings of abdominal and pelvic masses, hepatomegaly, and positive chest films. The average survival after discovery of recurrence was only eleven months, but 23 patients having reresections for cure lived an average of thirty-three months. Seven patients (30%) undergoing reresection for cure represented probable cures. Chemotherapy with intravenous 5-FU provided poor palliation, but radiotherapy gave satisfactory relief of symptoms in approximately 50% of patients, particularly those with rectal or low colon lesions. A program of follow-up is offered since there is evidence that even the symptomatic patient may be well palliated or even cured by surgical resection of the recurrence or palliative therapy.

Aged

Partial laryngectomy for recurrent cancer after irradiation.

Attention is drawn to the problems of surgical resection by partial laryngectomy after full therapeutic dosage of Telecobalt irradiation. Material is presented from 2 main treatment centres to indicate trends in surgical treatment and the complications experienced. End results are given which confirm a reasonable expectation of cure and functional conservation by vertical partial laryngectomy for recurrence of glottic cancer after irradiation. However, the results of treatment of recurrent supraglottic cancer by horizontal partial laryngectomy gave much cause for concern in terms of complications and survival. In conclusion an attempt is made, based on the quoted experience, to define the position of conservation surgery after full dosage irradiation of the larynx.

Adult

[Treatment of breast cancer recurrence with fast electrons].

During the period from July 1970 to July 1974 in the radiotherapy department of the N. N. Petrov Research Institute of Oncology of the USSR Ministry of Public Health 63 patients with breast cancer were treated with fast electrons. The irradiation technic employed in these patients allowed the occurrence of the early and late local radiation reactions and damages to be avoided. To improve the results of the treatment for local and regional recurrences and breast cancer metastases, it is necessary to elaborate some rational combinations of radiotherapy with general specific therapeutic measures.

Adult

Therapeutic embolization for hemorrhage from locally recurrent cancer of the breast.

Embolization therapy is reported in three patients bleeding from metastatic carcinoma of the breast. Two had life threatening hemorrhage from sternal erosion; internal mammary arteriography indicated encasement, false aneurysm formation or tumor blush. The third patient had intermittent bleeding of extensive fungating axillary and anterior chest wall metastases. Autologous clot alone was used in the first case with immediate cessation of bleeding and transient neurological symptoms secondary to back flow of thrombus into the vertebral artery were noted. The second and third patients received Oxycel-Ivalon and Gel-foam respectively; bleeding ceased and no complications were noted.

Breast Diseases